鄰里特徵對個人健康的影響
Effects of Neighborhood Characteristics on Individual Health
中文摘要
近年來，越來越多的研究指出，家戶周圍的鄰里環境會影響到一個人的健康。無 論是住家周圍菸酒的販賣，治安的狀況或是環境是否整潔，都會直接或間接影 響個人的行為和健康。本研究的目的主要是探討2000 年台灣地區鄰里特徵和個 人健康之間的關係。
研究資料來自台灣地區社會變遷基本調查第四期第一次調查計畫，將其20 歲以 上的受訪者的家戶地址相連到八十九年台閩地區戶口及住宅普查資料以提供鄰 里的資訊。研究對象為台灣地區20 歲以上成人。本研究以卡方檢定分析在不同的 個人因子和鄰里因子中，其個人健康差異的情形，並使用多層次分析(multi- level analysis)探討鄰里因子對個人健康的影響。
研究結果發現在控制個人因子之後，住在老人活動障礙比率越高的鄰里，居民 發生日常生活功能障礙的機會越高且自評健康越差。但是與我們預期不同的是鄰 里因子對於個人慢性病的發生沒有關係。
本研究結果部分印證了我們之前的研究假設，即加入個人因子之後，有些鄰里 因子仍然和個人健康是有相關的，且台灣地區鄰里之間有環境差異的情況。在政 策方面，本研究建議若要增加個人的健康，則鄰里環境的改善是很重要的，特 別是針對最弱勢的老人族群的社區，其社區組織和醫療服務都需要重整並加以 改善。
英文摘要
A growing number of studies indicated that individual health can be directly or indirectly affected by their neighborhood characteristics, such as neighborhood socioeconomic status and services. However, the influence of neighborhood characteristics on health remains unknown in Taiwan. This study examined whether neighborhood characteristics influence individual health in Taiwan.
The data came from the first wave of 2000 Social Change Study, which is a nationally representative study examining social issues in Taiwan. Participants’
residential addresses were geocoded with the 2000 census for measuring neighborhood characteristics (i.e., neighborhood percentage of people under 15 years of education). We used multi-level models to examine the associations between neighborhood-level characteristics and individual-level health.
Results indicated that there were significant neighborhood effects on self-rated health or functional limitations, but not on chronic condition, after adjusting for individual-level characteristics. Results showed that neighborhoods with a higher percentage of elderly and a higher percentage of people with functional limitation
were associated with individual poorer self-rated health and individual functional limitations. These relationships existed after taking into account individual characteristics.
The results of this study support the hypothesis that neighborhood characteristics can influence individual health in Taiwan. These results suggest that improving neighborhood context is critical for individual health, especially in the
neighborhoods where most residents are elderly or have functional limitation.
